Organization
MYSTIC SERVICES, LLC
Active
Other names
Mystic Bridge to Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN E ST. AMOUR MSW, LCSW (LICENSED CLINICAL SOCIAL WORKER)
(617) 416-0597
Entity
Organization
Contact information
Practice address
47 WATER ST STE 202, MYSTIC, CT 06355-2573
(617) 416-0597
(860) 415-0018
Mailing address
11 JOYCE ST, MYSTIC, CT 06355-2947
(617) 416-0597
(860) 415-0018
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/02/2020
Last updated
02/02/2020
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